Issues

Adolescence and young adulthood are periods of risk-taking and experimentation that often includes substance use. Schools and colleges are important settings in which to reach young people, although some vulnerable groups may not be well-represented within them.

In schools the focus is mainly on preventing or delaying the initiation of substance use and on the development of skills to support healthy decision-making.

Poor school attenders, frequent truants or young people with behavioural problems, such as poor impulse control, are at increased risk of developing problematic forms of substance use. This makes schools an important setting for early identification of at-risk individuals.

The greater independence of young people attending colleges and the tendency to increased alcohol and drug use in this age group make colleges an important setting for harm reduction and for referral of those developing problems to specialist services.

Response options

Drug use among school populations is generally low and can be part of a wider pattern of behavioural problems and risk-taking. Interventions therefore need to address the wider determinants of risky and impulsive behaviour rather than the drug use in isolation.

Most prevention interventions in schools aim at having an impact on the whole student body and staff. Those that are supported by current evidence include: evidence-based universal prevention programmes that focus on developing social competences and refusal skills, healthy decision-making skills, and correcting normative misperceptions about drug use;

school policies around substance use; and

interventions aimed at developing a protective and nurturing educational environment that is conducive to learning and establishes clear rules about substance use.

Other approaches that may be beneficial include events or interventions involving parents and the use of peer-to-peer approaches.

European picture

Of the interventions for which there is good evidence of effectiveness, smoking bans in schools are reported in all countries providing information, while 21 countries reported that school policies around substance use are in place in the majority of schools. Programmes aimed at developing personal and social skills are less widely implemented, with only 11 countries reporting them in the majority of schools. This is lower than the level of provision of information only programmes, which have not been found to be effective, but are reported in the majority of schools in 16 countries.

Some evidence exists in support of other types of programmes. Among these, peer-to-peer programmes seem to be relatively uncommon, but creative extracurricular activities and events for parents are more widely available. Drug testing of pupils is not recommended and is rarely used; it was only reported as being conducted in a few schools in 10 countries.

Summary of the available evidence

Interventions in schools and colleges

Response option

Quality of evidence

Effective school-based prevention programmes can delay initiation of use. These are manual-based and develop social competences and refusal skills, healthy decision-making and coping, and correct normative misperceptions about drug use. Ideally they should be provided within the context of a school drug policy.

moderate quality evidence

Substance use-related problems may be reduced by providing a protective and nurturing educational environment that is conducive to learning and establishes clear rules about substance use.

moderate quality evidence

There are evidence-based programmes for primary schools, which — without explicitly addressing substances — have effects on impulse-control and, therefore, potentially on later substance use and mental health problems. They have immediate effects on learning and classroom climate.

moderate quality evidence

Interventions that only provide information about the risks of drug use have not been found to be effective in preventing drug use.

Key

High quality evidence— one or more up-to-date systematic reviews that include high-quality primary studies with consistent results. The evidence supports the use of the intervention within the context in which it was evaluated.

Moderate quality evidence— one or more up-to-date reviews that include a number of primary studies of at least moderate quality with generally consistent results. The evidence suggests these interventions are likely to be useful in the context in which they have been evaluated but further evaluations are recommended.

Low quality evidence— where there are some high or moderate quality primary studies but no reviews available OR there are reviews giving inconsistent results. The evidence is currently limited, but what there is shows promise. This suggests these interventions may be worth considering, particularly in the context of extending services to address new or unmet needs, but should be evaluated.

Implications for policy and practice

Basics

Schools are important access points to the adolescent population and their parents. They also have a role in identifying at-risk individuals for targeted interventions.

Education systems should ensure schools provide evidence-based prevention programmes and have appropriate drug policies in place. These should aim not only to reduce substance use, but also to reduce violence, improve learning, produce better academic achievements and create a better school climate, outcomes that are of intrinsic interest to the education sector.

Ineffective prevention programmes are often popular, but there is a growing number of programmes that have been shown to work and these should be used instead.

Opportunities

Establishing systems that encourage or require schools and colleges to use programmes supported by evidence instead of ineffective programmes and providing the necessary support for this would be a more efficient use of resources.

Gaps

The evidence for effective programmes in colleges is very limited, but this is a period of high risk of drug use and appropriate programmes are needed for this setting.

Schools and colleges

Summary

Response option

Quality of evidence

Effective school-based prevention programmes can delay initiation of use. These are manual-based and develop social competences and refusal skills, healthy decision-making and coping, and correct normative misperceptions about drug use. Ideally they should be provided within the context of a school drug policy.

moderate quality evidence

Substance use-related problems may be reduced by providing a protective and nurturing educational environment that is conducive to learning and establishes clear rules about substance use.

moderate quality evidence

There are evidence-based programmes for primary schools, which — without explicitly addressing substances — have effects on impulse-control and, therefore, potentially on later substance use and mental health problems. They have immediate effects on learning and classroom climate.

moderate quality evidence

Interventions that only provide information about the risks of drug use have not been found to be effective in preventing drug use.

European picture

Of the interventions for which there is good evidence of effectiveness, smoking bans in schools are reported in all countries providing information, while 21 countries reported that school policies around substance use are in place in the majority of schools. Programmes aimed at developing personal and social skills are less widely implemented, with only 11 countries reporting them in the majority of schools. This is lower than the level of provision of information only programmes, which have not been found to be effective, but are reported in the majority of schools in 16 countries.

Some evidence exists in support of other types of programmes. Among these, peer-to-peer programmes seem to be relatively uncommon, but creative extracurricular activities and events for parents are more widely available. Drug testing of pupils is not recommended and is rarely used; it was only reported as being conducted in a few schools in 10 countries.

About the best practice portal

Disclaimer

While every effort is made to ensure that the information on this page is accurate and up to date, please note that it is not a substitute for the exercise of professional or clinical judgement and we do not intend you to rely upon it when making (or refraining from making) any clinical or individual decision. For more information, please see the Disclaimer in our legal notice.

Best practice definition

Best practice is the best application of available evidence to current activities in the drugs field.

underlying evidence should be relevant to the problems and issues affecting those involved (professionals, policymakers, drug users, their families);

methods should be transparent, reliable and transferable and all appropriate evidence should be considered in the classification process;

experience in implementation, adaptation and training should be systematically collected and made available;

contextual factors should be studied by modelling different prevalence levels so as to assess the impact of an intervention on the population; and

evidence of effectiveness and feasibility of implementation should both be considered for the broader decision-making process.

This definition was agreed by a group of experts including the Chairman of the EMCDDA Management Board João Goulão; members of the EMCDDA Scientific Committee; policymakers and top-level researchers in the areas of treatment, prevention and harm reduction.

Best practice portal

The Best practice portal is a resource for professionals, policymakers and researchers in the drugs field. We provide information on the available evidence on drug-related prevention, treatment and harm reduction, focusing on the European context. The evidence is compiled following an explicit methodological process, and is presented according to client profiles. The client profiles are designed according to the European data on illicit drug users collected at the EMCDDA. Currently, the profiles are organised around the main substance of use. We acknowledge that in reality people often use multiple drugs and the interventions provided might reflect this. We are therefore working on how best to accommodate this aspect in the future. In the portal we also provide an overview of the available quality standards and guidelines in the European Union (EU) Member States.

The portal was developed to respond to the EU drugs action plan (2009–12) and specifically to ‘enhance the quality and effectiveness of drug demand reduction activities, taking account of specific needs of drug users according to gender’. In particular, actions 17 and 19 aimed at exchanging ‘good practice guidelines/quality standards for prevention, treatment, harm reduction and rehabilitation interventions and services’ and ‘to develop an EU consensus on minimum quality standards and benchmarks for prevention, treatment, harm reduction and rehabilitation’.

The portal will be continuously updated as information and research on interventions emerges.

Acknowledgments

Alan Lodwick

Angelina Brotherhood

Artur Malczewski

Ave Tallu

Charlotte Davies

Elias Allara

Fabrizio Faggiano

Franz Trautman

Joao Goulao

John Strang

Laura Amato

Marina Davoli

Marion Weigl

Maurizio Coletti

Michael Farrell

Peer Van der Kreeft

Richard Velleman

Tim Pfeiffer-Gerschel

Collaborations and patnerships with external organisations

Below are some of the ongoing collaborations and partnerships involving the EMCDDA's Best practice portal and external organisations.

Collaborations and partnerships in best practice

About the EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU’s decentralised agencies. Read more >>